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General NPI Number Information
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NPI Number | 1932203106
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Entity Type | Individual
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Provider Name | NITA MARIE RAGLE PA
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Gender | Female
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 4701 BRYANT IRVIN RD N
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City | FORT WORTH
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State | TX
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Zip | 76107-7627
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Country | US
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Telephone | 817-702-1100
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Fax | 817-569-9069
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Provider Business Mailing Address
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Address Line | 301 CLIFFORD CENTER DR STE 115
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City | FORT WORTH
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State | TX
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Zip | 76108-4444
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Country | US
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Telephone | 817-737-6552
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Fax | 817-732-6597
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA03158
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License Number State | TX
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